A family is a big part of people’s lives, especially in tough times, such as when a loved one is battling a substance addiction. Addiction affects more than one person; it affects the entire family. Someone’s drinking or drug use can have adverse effects on everyone that can last a lifetime. Thoughts, actions, and behaviors that accompany addiction can disrupt home life and create an environment of fear, distrust, and danger.
“Families with alcohol and drug problems usually have high levels of stress and confusion.”
There is research that suggests children who grow up in homes where substance use disorders can develop can struggle with emotional and behavioral problems that can change or shape them as adults. They also are at a higher risk of using and/or abusing substances themselves.
“The negative impacts of parental SUDs on the family include disruption of attachment, rituals, roles, routines, communication, social life, and finances. Families in which there is a parental SUD are characterized by an environment of secrecy, loss, conflict, violence or abuse, emotional chaos, role reversal, and fear,” according to research titled, “The Impact of Substance Use Disorders on Families and Children: From Theory to Practice.”
High-stress family environments are a risk factor for early and dangerous substance use, as well as mental and physical health problems,” says a passage in a publication published by the Substance Abuse and Mental Health Services Administration (SAMHSA).
The person who is abusing substances often becomes the primary focus of attention, and loved ones adjust to this reality in various ways. In families with alcohol and drug problems, relatives often adopt various roles based on the behavior they exhibit as they try to come to terms with a loved one’s substance abuse issues and interact with the person. Some family members may retreat and avoid the person to protect their own feelings and personal boundaries while others will jump in and try to manage their loved ones as they see fit. Some may even enable their loved one, whether knowingly or unknowingly, or bargain with them to stop using.
While all of these reactions are understandable, none of them truly helps the person in need of drug or alcohol treatment. The decision to commit to treatment rests with the person who is battling an addiction, but family or close loved ones do share some responsibility in what happens in the family environment when addiction shows up there. The role of the family should not be overlooked by anyone who wants to see their loved one recover from this debilitating brain disease.
It is widely believed that in families with alcohol and drug problems, the roles of family members are based on their behavior and how they see themselves. They also can change roles at any time. Sharon Wegscheider-Cruse, a consultant and founding chairperson of the National Association for Children of Alcoholics, says there are six main roles at work in a family that is grappling with a loved one that is abusing alcohol and drugs. These roles can apply to a variety of relationships, including parent-child, child-parent, husband-wife, sibling-sibling, and many more They are:
The Dependent. The Dependent is the person who is having substance abuse and addiction issues and needs recovery to get their life back on track.
This person uses substances to cope with life’s pressures and conflicts and may engage in unhealthy coping behaviors as they try to relate to others. The need to use will continue to spiral out of control, and the Dependent’s behavior will take its toll on surrounding family members who will deal with their loved one in their own way.
This person may or may not reach a point that something must change on their own without the help of family or other loved ones.
The Enabler. The Enabler will do whatever it takes to smooth over their loved one’s addiction.
This person is worried about their loved one and wants them to get better, but the person struggles with figuring out how to be there for the person. They are in denial of their loved one’s condition and may even make excuses or lie to cover up for the person’s addiction.
Unfortunately, their words and actions only encourage the person to continue on a path that isn’t good for them. The Enabler can be a spouse, partner, or even a child and struggles with allowing their addicted loved to one face the full consequences of their substance abuse.
The Family Hero. The Family Hero, often the eldest child, steps in to care for the family in the place of the person who is addicted. In many cases, this person is a hard-working, high achiever who appears to have it all together. The person takes on stress and feels personally responsible for what is taking place and figuring out how to make things “right” again. This person works to make things as normal as possible to help keep the family on track. This perfectionist approach eventually catches up with the Family Hero, leaving the stressed out, anxious, and possibly disappointed.
The Scapegoat. The Scapegoat is wrongly blamed for the challenges and difficulties in the family to distract from the addict’s behavior. They also could be blamed for situations they had nothing to do with. In some cases, the Scapegoat will begin to believe how they are perceived and come to loathe themselves and develop low self-esteem. They also may develop trust issues.
The Mascot. The Mascot, usually the youngest child in the family, tries to find the humor in a heavy situation and ease stressful, tension-filled situations by making their family members laugh and smile. They try to keep things light to avoid the weight of their loved one’s addiction. Laughter shields the Mascot from their own feelings about their loved one’s addiction.
The Lost Child. The Lost Child may or may not take this role by choice. Either way, the person is the child whose needs were overlooked and neglected while growing up in an environment affected by substance addiction. This person may become withdrawn and do everything possible to remain out of the spotlight. They deal with their loved one’s addiction by staying out of the way and avoiding family conflicts until they are possibly cornered to do so.
Each of the people in these roles is dealing with a family member’s addiction in the way that they know how. The fact that they all have different approaches to their family member’s addiction means that inevitably, they are not going to get along, which will cause conflict among them. As these disagreements occur over time, they may become frequent and more intense. And, of course, none of the discord is helping the addicted person or the people who are affected by it.
To shed these roles, every family member will have to take an honest look at their role and how it contributes to the family’s struggles with their loved one’s substance abuse issues and what they can do to change their behavior. Family therapy can help everyone find better and healthier ways to cope and end behaviors that only fuel their loved one’s addiction, not help end it.
Family members will not get along all of the time as no family or person is perfect. However, there are challenges that can contribute to or worsen one’s addiction. If any of these exist in the family environment, a person in active addiction may struggle even further. They are:
All of the above can contribute to tensions and stress in the home environment. Tensions and stress can be triggering for a person who is in active addiction, so they seek out substances as they either try to deal with them or avoid them altogether. If you recognize any of these situations in your own family, and you are trying to help a person who can’t stop abusing drugs, alcohol, and/or other addictive substances, you may want to consider family therapy and/or joining support groups that can help you be there for your loved one.
Support groups include:
Al-Anon Family Groups (www.al-anon.org)
Alcoholics Anonymous (www.aa.org)
Adult Children of Alcoholics (www.adultchildren.org)
Source: Substance Abuse and Mental Health Services Administration
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There’s nothing easy about addiction.
Confronting it without the proper tools and techniques in place will just frustrate relatives and the people with substance abuse issues. And avoiding it will just contribute to further deterioration of the family and their environment. Professional therapy designed for families can help repair dysfunctional relationships that contribute to substance abuse.
This kind of therapy is not just for the person in addiction; it’s also for the people who love and care about them and want to see them live healthier and happier lives. Family members can best help a loved one who’s going through addiction as well as work on themselves, and family therapy can help them do that.
At Delphi Behavioral Health Group, we encourage families to address their loved one’s addiction or substance abuse problem together. No matter where your loved one is in on their path, it is not too late to get them help, and you can be there for them as they do. Treatment programs at Delphi Behavioral Health Group’s facilities provide unique therapy and counseling methods for certain addictions.
Lander, Laura, Janie Howsare, and Marilyn Byrne. (2013). “The Impact of Substance Use Disorders on Families and Children: From Theory to Practice.” Social work in public health 28.0 (2013): 194–205. PMC. Retrieved June 2018 at from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3725219/
National Institute on Drug Abuse. (2014) “Drugs, Brains, and Behavior: The Science of Addiction.” Retrieved June 2018 from from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment
SAMHSA. “Alcohol and Drug Addiction Happens in the Best of Families… and It Hurts.” Substance Abuse and Mental Health Services Administration. Retrieved June 2018 at from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3725219/